Pattern of Opioid Prescriptions Among Patients With Breast, Lung, and Colorectal Cancer Diagnosed With Chronic Non-Malignant Pain
Author(s)
Safalta Khadka, MS1, J. Douglas Thornton, PharmD, PhD2, Khalid M. Kamal, PhD3, Gerald Higa, Pharm D3, Kimberly Kelly, PhD4, Sabina O. Nduaguba, PhD3;
1West Virginia University, Graduate Teaching Assistant, Morgantown, WV, USA, 2University of Houston, Houston, TX, USA, 3West Virginia University, Morgantown, WV, USA, 4The University of Tennessee, Knoxville, TN, USA
1West Virginia University, Graduate Teaching Assistant, Morgantown, WV, USA, 2University of Houston, Houston, TX, USA, 3West Virginia University, Morgantown, WV, USA, 4The University of Tennessee, Knoxville, TN, USA
OBJECTIVES: Chronic non-malignant pain (CNMP) due to comorbid conditions presents a barrier to optimal pain management in patients with cancer. The study objective is to determine the frequency of use and pattern of opioid prescriptions for CNMP among patients with active cancer.
METHODS: A retrospective cohort study was conducted utilizing Surveillance Epidemiology and End Results (SEER)-Medicare linked database from 2006 to 2018. Patients, at least 66 years old with histologically confirmed diagnoses of breast, lung, and colorectal cancer from 2007 to 2017, were included in the study. Patients with CNMP were identified using ICD9 and ICD10 codes and control-group (patients without CNMP) were selected using a 1:4 matching process with CNMP patients, based on age, sex, cancer type and cancer diagnosis date. The follow-up period was one year after the index date and the primary outcome was opioid use. Multivariable logistic regression was used to compare opioid use and opioid prescription patterns among the two groups.
RESULTS: In total, 151,863 [Case (n) = 35,120, Control (n) =116,743)] patients were included in the study with 40.60% diagnosed with lung cancer (n=61,662), followed by breast cancer (n=47,203, 31.08%) and colorectal cancer (n=42,998, 28.31%). The overall rate of opioid use was 30.12% (breast cancer = 30.98%, lung cancer = 30.96%, and colorectal cancer = 27.99%). Among patients prescribed with opioids, 6.02% patients were prescribed with high dose of opioids (>=90 MME/day). The odds of opioid prescriptions were higher among patients with CNMP (OR = 1.33, 95% CI = 1.29-1.36) compared to the control-group. Further, within the CNMP group, patients with lung cancer and colorectal cancer had higher odds of opioid prescriptions compared to patients with breast cancer (OR=1.23, 95% CI 1.19-1.27, p <0.01, OR= 1.08, 95% CI 1.01-1.16, p<0.01) respectively.
CONCLUSIONS: The burden of CNMP in patients with active cancer necessitates a meticulous approach to opioids prescribing.
METHODS: A retrospective cohort study was conducted utilizing Surveillance Epidemiology and End Results (SEER)-Medicare linked database from 2006 to 2018. Patients, at least 66 years old with histologically confirmed diagnoses of breast, lung, and colorectal cancer from 2007 to 2017, were included in the study. Patients with CNMP were identified using ICD9 and ICD10 codes and control-group (patients without CNMP) were selected using a 1:4 matching process with CNMP patients, based on age, sex, cancer type and cancer diagnosis date. The follow-up period was one year after the index date and the primary outcome was opioid use. Multivariable logistic regression was used to compare opioid use and opioid prescription patterns among the two groups.
RESULTS: In total, 151,863 [Case (n) = 35,120, Control (n) =116,743)] patients were included in the study with 40.60% diagnosed with lung cancer (n=61,662), followed by breast cancer (n=47,203, 31.08%) and colorectal cancer (n=42,998, 28.31%). The overall rate of opioid use was 30.12% (breast cancer = 30.98%, lung cancer = 30.96%, and colorectal cancer = 27.99%). Among patients prescribed with opioids, 6.02% patients were prescribed with high dose of opioids (>=90 MME/day). The odds of opioid prescriptions were higher among patients with CNMP (OR = 1.33, 95% CI = 1.29-1.36) compared to the control-group. Further, within the CNMP group, patients with lung cancer and colorectal cancer had higher odds of opioid prescriptions compared to patients with breast cancer (OR=1.23, 95% CI 1.19-1.27, p <0.01, OR= 1.08, 95% CI 1.01-1.16, p<0.01) respectively.
CONCLUSIONS: The burden of CNMP in patients with active cancer necessitates a meticulous approach to opioids prescribing.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH72
Topic
Epidemiology & Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Geriatrics, SDC: Mental Health (including addition), SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), SDC: Oncology